Docetaxel Activity in the Era of Life-prolonging Hormonal Therapies for Metastatic Castration-resistant Prostate Cancer.

Abstract

For >6 yr, docetaxel with prednisone was the only treatment with survival benefits for metastatic castration-resistant prostate cancer (mCRPC). More recently, in clinical practice, abiraterone acetate has been commonly administered prior to docetaxel for the treatment of mCRPC. Our study aimed to review the activity of docetaxel after prior abiraterone. To this end, we analyzed all retrospective reports in the literature describing the overall survival (OS) of mCRPC patients treated with docetaxel after previous abiraterone. The mean OS observed was 12.7 mo, which suggested a significant decrement compared with the 19.2 mo seen in the updated analysis of the TAX 327 study; however, the data are quite similar to the OS of 13.6 mo (95% confidence interval, 12.1-15.1 mo) described in a retrospective single-institution study of 357 men with mCRPC treated with docetaxel with no prior abiraterone mostly in routine practice (86.3%). Because the characteristics of patients recruited in phase 3 trials tend to differ from the real-world setting, we deemed this data set a relevant comparison. Consequently, despite the limitations of retrospective cross-study comparisons, the data suggest that docetaxel retains activity when used as second-line therapy after abiraterone for mCRPC patients. We reviewed the activity of docetaxel after prior use of abiraterone and considered the results in the light of the outcomes of docetaxel used as first-line therapy for metastatic castration-resistant prostate cancer (mCRPC) patients in routine practice. We noted that docetaxel retains reasonable activity and is a useful agent for the treatment of mCRPC patients before or after abiraterone.